What is Reproductive Surgery?
Reproductive surgery for males refers to surgical procedures or microsurgical sperm retrieval techniques designed to retrieve sperm or correct anatomical issues that affect fertility.
At Sunfert, we offer advanced microsurgical and minimally invasive techniques to help men with obstructive or non-obstructive fertility challenges achieve biological parenthood.
These procedures are performed by our experienced fertility specialists using precision technology to maximise the chances of successful sperm retrieval.
Male reproductive surgery is typically recommended when:
- sperm is absent in the ejaculate (Azoospermia)
- there is a blockage preventing sperm release
- previous sperm analysis shows severely low sperm count
- assisted reproductive treatment requires direct sperm retrieval
Notes:
- Azoospermia: A condition where no sperm is found in the semen, leading to male infertility.
- Non-obstructive Azoospermia: A form of azoospermia caused by impaired or absent sperm production in the testes.
- Obstructive Azoospermia: A form of azoospermia caused by a blockage that prevents sperm from being present in the semen despite normal sperm production.
Types of Reproductive Surgery for Males
There are 4 main types of minimally invasive reproductive surgery for males available at Sunfert:
Microsurgical Testicular Sperm Extraction (MESA)
Percutaneous Testicular Sperm Aspiration (PESA)
Testicular Sperm Aspiration (TESA)
Testicular Sperm Extraction (TESE)
What is MESA, PESA, TESA and TESE?
Microsurgical Testicular Sperm Extraction (MESA)
MESA is an advanced surgical procedure where we use an operating microscope to carefully identify and extract sperm directly from the testicular tissue.
This technique allows us to precisely locate tiny areas where sperm production may still be occurring, even in challenging cases.
Percutaneous Testicular Sperm Aspiration (PESA)
PESA is a minimally invasive procedure where we use a fine needle to extract sperm from the epididymis. It is performed under local anaesthesia and does not require open surgery.
Note:
- Local anesthesia is used to temporarily numb a specific area of the skin, underlying tissue, and peripheral nerves to reduce pain during minor procedures.
Testicular Sperm Aspiration (TESA)
TESA involves using a needle to extract sperm directly from the testicle. Unlike open surgical methods, TESA is performed through needle aspiration, making it a straightforward and minimally invasive option.
Testicular Sperm Extraction (TESE)
TESE is a minor surgical procedure where we remove a small biopsy of testicular tissue to extract sperm. The tissue sample is carefully examined in our laboratory to identify viable sperm for fertilisation.
The Difference Between MESA, PESA, TESA and TESE
| Aspect | MESA | PESA | TESA | TESE |
|---|---|---|---|---|
| Procedure Method | Microsurgical retrieval of sperm from the epididymis | Needle aspiration of sperm from the epididymis | Needle aspiration of sperm directly from testicular tissue | Surgical biopsy of testicular tissue to extract sperm |
| When It’s Used | Obstructive azoospermia (blocked sperm ducts) | Obstructive azoospermia | Epididymal sperm unavailable or prior procedure failed | Non-obstructive azoospermia (low or no sperm production) |
| Key Features | High-quality sperm, requires microsurgery | Less invasive, quick outpatient procedure | Simple outpatient procedure, sperm from testicle | Multiple biopsies may be performed for better yield |
| Recovery Time | Minor recovery, small incision | Minimal discomfort, fast recovery | Minor soreness, local anesthesia | Small surgical site, short recovery |
Take the Next Step with Our Fertility Specialists
If you are facing fertility challenges or considering embryo freezing for future family planning, start with a consultation at Sunfert. We will guide you through your fertility journey with expertise and compassionate care.
Make an appointment with our Fertility Specialist today and take the next step toward your parenthood goals.
Frequently Asked Questions About Male Reproductive Surgery
Question #1: Is Microsurgical Testicular Sperm Extraction (MESA) painful and how long is recovery?
- MESA is performed under anaesthesia to minimise discomfort.
- Recovery typically takes a few days, and most men return to light activities within a short period.
Question #2: Is Percutaneous Testicular Sperm Aspiration (PESA) safe for men with Obstructive Azoospermia?
- Yes. PESA is considered safe and effective for men with blockage-related infertility, as it retrieves sperm without the need for open surgery.
Question #3: Can Testicular Sperm Aspiration (TESA) be repeated if the first attempt fails?
- Yes. TESA can be repeated if necessary, depending on medical assessment and sperm retrieval outcomes.
Question #4: When is Testicular Sperm Extraction (TESE) recommended over needle-based procedures?
- TESE may be recommended when needle aspiration methods do not successfully retrieve sperm or when more tissue sampling is required for better chances of sperm identification.